The Good and Bad News About Stomachaches

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Most stomachaches are nothing more than indigestion or gas. But stomach pain also could be appendicitis, gallstones, or a tubal pregnancy. The characteristics of the pain and its severity, location, and duration are clues to its cause.

What to ask

These are questions to consider when describing the pain to your health care provider:

Where is the pain? Is it in the upper, middle, or lower abdomen? Is it on one side only or on both sides?

Does the pain stay in one spot or does it seem to travel?

Is it related to eating or going to the bathroom?

Does it come and go or stay the same?

Does anything make it worse or better?

Also, tell your health care provider if you have vomited or have diarrhea; if you had blood in the vomit, diarrhea, or urine; and if you have other symptoms such as shortness of breath, dizziness, or a fever.

The usual suspects

Appendicitis requires immediate medical attention. The symptoms typically start with a loss of appetite, mild fever, pain around the belly button, vomiting, diarrhea, or constipation. The pain usually moves to the belly’s lower right side.

Diverticulitis can feel like appendicitis, except the pain is in the lower left side of the abdomen. The pain is usually severe and comes on suddenly.

Food poisoning causes nausea, vomiting, abdominal cramps, and diarrhea. Symptoms can occur within 30 minutes or up to two days after eating contaminated food.

Gallstones can cause steady pain in the upper abdomen that increases rapidly and lasts from 30 minutes to several hours. Other symptoms include abdominal bloating, gas, and indigestion.

Irritable bowel syndrome is one of the most common disorders diagnosed by doctors. Abdominal pain, bloating, and discomfort are the main symptoms.

Ectopic or tubal pregnancy symptoms include abdominal or pelvic pain. It can be sudden, persistent, and severe but also may be mild. If a fallopian tube has ruptured, which is a medical emergency, there also may be signs of shock, such as a weak, racing pulse; pale, clammy skin; and dizziness or fainting.

Ovarian cancer symptoms can include periodic pelvic and abdominal pain. Other symptoms include more frequent urination and a more frequent urge to urinate; increased abdominal pan or bloating; and a feeling of fullness.

Treatment decisions

The following guidelines can help you determine how to respond to stomach pain:

Self-treat if the pain is mild.

See your doctor if the pain is mild to moderate and recurs over time.

Go to the emergency room if your pain is severe or if you have a fever or blood in your vomit or bowel movement.

Any pain that’s severe or interferes with your ability to go about your usual routine should be evaluated by a doctor.